Dinah, ClinkShrink, & Roy produce Shrink Rap: a blog by Psychiatrists for Psychiatrists, interested bystanders are also welcome. A place to talk; no one has to listen.

Wednesday, January 10, 2007

Over 20 Billion Served

I got my 2006 statistics today. Coincidentally, my facility also had its annual surprise state audit today so the numbers came in handy. I have seen 10% more patients this year than last year at just one of my many work sites. I see as many patients in a given year as some small regional hospitals admit. Just out of curiosity I sat down and ran some numbers using very very conservative estimates, and I figured that over the time since I've finished my training I have treated at least 35,100 inmates.

I wasn't planning to blog about this, except that over at JR's Thumbprints recently he was posting about his recent audit and his prison system's factory approach to education. He was exactly right---how do you know what numbers are 'right'? If I see 3000 patients a year am I a better correctional clinician than someone who 'only' sees 1000 patients a year? What if there are actually 6000 inmates who need to be seen? Or only 500? Are we missing our target or overshooting?

The emphasis shouldn't be solely on the size of your clinic (although to be fair many correctional systems probably can't even give you an estimate about that) but it should also include measures of how long it takes someone to get seen once they're identified as needing treatment, how well they are tracked through the correctional system and how well the system is able to identify returning patients. There's just more to good quality control statistics than caseload size.

To quote that old Wendy's commercial: "Where's the beef?" My beef is here---with the numbers.

You know that they can't give medical advice here, no matter what. Do you have an EAP (employee assistance program)? It sounds like you need to talk to someone. I thought I would respond to you because I am a psych patient so I am familiar with emotional pain and it sounds as if you are suffering.

This blog belongs to three very caring psychiatrists, but it would be unprofessional and unethical for them to advise you without seeing you.

Oh my gosh, anonymous, thank you for the sympathy, but if you're responding to my comment that "My life is meaningless" it was me, dinah, responding to the the fact that Clink sees a zillion patients, and I see a few hours a day of psychotherapy patients. At the clinic, I see maybe 4-7 patients in a morning, in my office, 1 an hour. She may see more patients in a year then I see in my career, I'm just not sure how (or why). My life isn't really meaningless, I have Max the dog, the blog, the kids, my writing, my practice, Clink, Roy, my husband whose fidelity will be the subject of the next post. All I'm missing is a few thousand criminals. Thank you for the kind words. And yes, that is ClinkShrink on the right!

Clink, i'm curious as to why they give you these statistics anyways. Are they meant to be benchmarks for the future, or is it just "thought you might be interested so here's some more data that you'll never need"?

WHat's the point of seeing patients if they lose every semblance of individuality? Maybe i'm reading too much into this - i'm waiting for a new post on the blog.

Dinah: Why does Max get first billing on your list of important life things? He must be thrilled. I knew it was your comment immediately---when you write anonymously you never capitalize. It's like reading Don Marquis.

Anonymous #2: Yes, treatment outcome measures would be good to have but right now most systems are struggling just to make sure their patients get identified and treated in the first place. Once that's being done reliably we should look at outcomes, and also cost-benefit studies too since no taxpayer is going to vote for more money to care for inmates unless there's someone financial incentive to do it.

Lily: I haven't been on the far right since the 2000 presidential election :)

Rach: Yes, they're benchmarks so that they can plan for future needs & spot trends. It's a beginning but no where near where it needs to be.

And to all of you who were concerned about Dinah-anonymous, that was very sweet of you. I can verify that she has a wonderful life with a peaceful and predictable practice but I'll be darned if I know how she juggles the off-duty chaos. I have chaos at work but when I come home it's peace, quiet and pleasant predictability.

Either way you look at the numbers, you have made a tremendous impact on many, many lives, not just those of the inmates, but of their significant others and children as well (assuming they get out someday).

Kudos to you for all that you do!

I miss your little drawings. They are cute, although when I look at the nun one with the crazy eyes, rapacious smile and gigantic stomping feet, I get a little nervous. Is it because I'm Catholic?

I also wondered about the order of Dinah's list! Great minds think alike--oh oh for you on that one--but I feel denied. Where is Dinah's post about her husband's fidelity? I hope it's a scorcher, but I hope Max isn't involved ; )